Diabetes Treatment Satisfaction Questionnaire Research Articles

Sex-driven factors associated with anxiety and depression in autoimmune diabetes.

To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors. In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy),to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4months from the questionnaires' administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled). Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31-0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1year increase, 95% CI 0.92-1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1mmol/mol increase, 95% CI 1.03-1.13; p = 0.002). Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females.

Effects, Safety, and Treatment Experience of Advanced Hybrid Closed-Loop Systems in Clinical Practice Among Adults Living With Type 1 Diabetes.

There are few studies providing a more comprehensive picture of advanced hybrid closed-loop (AHCL) systems in clinical practice. The aim was to evaluate the effects of the AHCL systems, Tandem® t: slim X2™ with Control IQ™, and MiniMed™ 780G, on glucose control, safety, treatment satisfaction, and practical barriers for individuals with type 1 diabetes. One hundred forty-two randomly selected adults with type 1 diabetes at six diabetes outpatient clinics in Sweden at any time treated with either the Tandem Control IQ (TCIQ) or the MiniMed 780G system were included. Glycated hemoglobin A1c (HbA1c) and glucose metrics were evaluated. Treatment satisfaction and practical barriers were examined via questionnaires. Mean age was 42 years, median follow-up was 1.7 years, 58 (40.8%) were females, 65% used the TCIQ system. Glycated hemoglobin A1c was reduced by 0.6% (6.8 mmol/mol; 95% confidence interval [CI] = 0.5-0.8% [5.3-8.2 mmol/mol]; P < .001), from 7.3% to 6.7% (57-50 mmol/mol). Time in range (TIR) increased with 14.5% from 57.0% to 71.5% (95% CI = 12.2%-16.9%; P < .001). Time below range (TBR) (<70 mg/dL, <3.9 mmol/L) decreased from 3.8% to 1.6% (P < .001). The standard deviation of glucose values was reduced from 61 to 51 mg/dL (3.4-2.9 mmol/L, P < .001) and the coefficient of variation from 35% to 33% (P < .001). Treatment satisfaction increased, score 14.8 on the Diabetes Treatment Satisfaction Questionnaire (DTSQ) (change version ranging from -18 to 18, P < .001). Four severe hypoglycemia events were detected and no cases of ketoacidosis. Skin problems were experienced by 32.4% of the study population. Advanced hybrid closed-loop systems improve glucose control with a reasonable safety profile and high treatment satisfaction. Skin problems are common adverse events.

Using person reported outcomes: Psychometric properties of the German diabetes treatment satisfaction questionnaire (DTSQ) for teens and parents

AimsTo examine psychometric properties including the factor structure of the German versions of the Diabetes Treatment Satisfaction Questionnaire for teens and parents (DTSQ-T/-P). MethodsLinguistically validated questionnaires were completed by 363 adolescents with type 1 diabetes and 655 parent-caregivers in a multicenter study. Confirmatory factor analysis (CFA), reliability, and correlations were examined. ResultsCFA confirmed the 2-factor model of treatment satisfaction (TS) &perceived diabetes control (PDC) with an adjustment of removing the “medical support” item from the TS and examining it as a single item in this study. Cronbach's α of TS for DTSQ-T/-P was 0.82 & 0.83, respectively, and α of the two-item PDC factor was 0.70 & 0.60, respectively. The DTSQ scale scores positively correlated with time in range and inversely correlated with HbA1c. Scale scores of DTSQ-T/-P showed significantly positive relations to the KIDSCREEN-10 Index and negative associations with the Problem Areas in Diabetes (PAID). The TS of the parents was correlated with depressive symptoms measured in the Patient Health Questionnaire-9. ConclusionsThe DTSQ-T/-P produced psychometrically sound scores in measuring diabetes treatment satisfaction in German teens with type 1 diabetes and their parents. German DTSQ versions for teens and parents are recommended in research and clinical practice.

Neonatal Birth Weight With Daily Compared With Every-Other-Day Glucose Monitoring in Gestational Diabetes Mellitus

OBJECTIVE: To assess whether universal use of every-other-day glucose monitoring in patients with gestational diabetes mellitus (GDM) resulted in similar birth weights and medication use and was preferred by the patient compared with traditional daily glucose monitoring. METHODS: This was a noninferiority randomized controlled trial conducted at a single New York City hospital between April 2021 and May 2022. Patients with singleton pregnancies who were diagnosed with GDM after 20 weeks of gestation and had a minimum of 7 days of previous daily blood glucose testing were randomly assigned to test blood glucose values daily or every other day. The primary outcome was neonatal birth weight. We calculated a total sample size of 196 participants needed for noninferiority to be tested, assuming the mean birth weight in the every-other-day group, compared with the daily group, was no higher than the predefined noninferiority margin of 200 g (80% power and one-sided alpha of 0.05). Postrandomization characteristics, including blood glucose values and medication initiation and timing, were recorded. Satisfaction with treatment group was assessed using the validated Oxford Maternity Diabetes Treatment Satisfaction Questionnaire. RESULTS: A total of 197 patients were randomized: 98 in the daily group and 99 in the every-other-day group. Baseline characteristics were similar between groups. The mean neonatal birth weight was similar between groups (mean±SD 3,090±418 g among newborns in the daily group compared with 3,181±482 g among newborns in the every-other-day group). For the primary outcome, the every-other-day group was found to be noninferior to the daily group with an upper confidence limit for the mean difference in mean birth weight of 197 g, which was below the noninferiority margin of 200 g (P=.046). Postrandomization, there were no significant differences in the number of patients who required medication, the gestational age at which medication was started, or the type of medication used. Average fasting and postprandial glucose values were similar between groups. There was an increase in adherence to treatment group in those randomized to every-other-day blood sugars, but no difference in patient satisfaction. CONCLUSION: In patients with GDM, testing blood glucose values every other day was as effective as testing daily, without apparent effects on birth weight, medication initiation, or glucose control. Reduced frequency of blood glucose monitoring might help decrease the emotional, physical, and financial burden experienced by patients with GDM. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT04857073.

Impact of personalized diabetes care on distress and treatment satisfaction in people with breast cancer.

In patients with breast cancer (BCa) and diabetes (DM), diabetes distress (DD) and treatment satisfaction (DTS) can influence BCa management and outcomes. We assessed the impact of implementing a personalized diabetes care model in patients with BCa. Patients in active treatment or surveillance for BCa with an HbA1c > 53 mmol/mol (7%) or random blood glucose >11.1 mmol/L were included. Participants were offered continuous glucose monitoring (CGM), virtual care and a dedicated diabetes provider for 6 months. Primary outcomes included DD measured by the Diabetes Distress Survey (DDS) and DTS measured by the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Questionnaires were conducted at 0, 3 and 6 months. Thirty-one women were enrolled (median age 61, IQR 49.0-69.0). Compared to baseline, the mean DDS score was lower at both 3 months (2.2 vs. 1.8 [n = 27], p = 0.004, SD = 0.70) and 6 months (2.3 vs. 1.8 [n = 23], p = 0.002, SD = 0.70). The mean DTSQ score was higher at 3 months (baseline: 20.5 vs. 3 months: 28.7 [n = 28], p < 0.001, SD = 9.2) and 6 months (baseline: 20.4 vs. 6 months: 30.0 [n = 26], p < 0.001, SD = 9.7). Personalized diabetes care models that emphasize remote management and optimize access for those with BCa may lower DD and improve DTS.

Effects of Digitization of Self-Monitoring of Blood Glucose Records Using a Mobile App and the Cloud System on Outpatient Management of Diabetes: Single-Armed Prospective Study.

In recent years, technologies promoting the digitization of self-monitoring of blood glucose (SMBG) records including app-cloud cooperation systems have emerged. Studies combining these technological interventions with support from remote health care professionals have reported improvements in glycemic control. To assess the use of an app-cloud cooperation system linked with SMBG devices in clinical settings, we evaluated its effects on outpatient management of diabetes without remote health care professional support. In this multicenter, open-label, and single-armed prospective study, 48 patients with diabetes (including type 1 and type 2) at 3 hospitals in Japan treated with insulin or glucagon-like peptide 1 receptor agonists and performing SMBG used the app-cloud cooperation system for 24 weeks. The SMBG data were automatically uploaded to the cloud via the app. The patients could check their data, and their attending physicians reviewed the data through the cloud prior to the patients' regular visits. The primary outcome was changes in glycated hemoglobin (HbA1c) levels. Although HbA1c levels did not significantly change in all patients, the frequency of daily SMBG following applying the system was significantly increased before induction at 12 (0.60 per day, 95% CI 0.19-1.00; P=.002) and 24 weeks (0.43 per day, 95% CI 0.02-0.84; P=.04). In the subset of 21 patients whose antidiabetic medication had not been adjusted during the intervention period, a decrease in HbA1c level was observed at 12weeks (P=.02); however, this significant change disappeared at 24 weeks (P=.49). The Diabetes Treatment Satisfaction Questionnaire total score and "Q4: convenience" and "Q5: flexibility" scores significantly improved after using the system (all P<.05), and 72% (33/46) patients and 76% (35/46) physicians reported that the app-cloud cooperation system helped them adjust insulin doses. The digitization of SMBG records and sharing of the data by patients and attending physicians during face-to-face visits improved self-management in patients with diabetes. Japan Registry of Clinical Trials (jRCT) jRCTs042190057; https://jrct.niph.go.jp/en-latest-detail/jRCTs042190057.

Psychosocial Outcomes Among Users and Nonusers of Open-Source Automated Insulin Delivery Systems: Multinational Survey of Adults With Type 1 Diabetes.

Emerging research suggests that open-source automated insulin delivery (AID) may reduce diabetes burden and improve sleep quality and quality of life (QoL). However, the evidence is mostly qualitative or uses unvalidated, study-specific, single items. Validated person-reported outcome measures (PROMs) have demonstrated the benefits of other diabetes technologies. The relative lack of research investigating open-source AID using PROMs has been considered a missed opportunity. This study aimed to examine the psychosocial outcomes of adults with type 1 diabetes using and not using open-source AID systems using a comprehensive set of validated PROMs in a real-world, multinational, cross-sectional study. Adults with type 1 diabetes completed 8 validated measures of general emotional well-being (5-item World Health Organization Well-Being Index), sleep quality (Pittsburgh Sleep Quality Index), diabetes-specific QoL (modified DAWN Impact of Diabetes Profile), diabetes-specific positive well-being (4-item subscale of the 28-item Well-Being Questionnaire), diabetes treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire), diabetes distress (20-item Problem Areas in Diabetes scale), fear of hypoglycemia (short form of the Hypoglycemia Fear Survey II), and a measure of the impact of COVID-19 on QoL. Independent groups 2-tailed t tests and Mann-Whitney U tests compared PROM scores between adults with type 1 diabetes using and not using open-source AID. An analysis of covariance was used to adjust for potentially confounding variables, including all sociodemographic and clinical characteristics that differed by use of open-source AID. In total, 592 participants were eligible (attempting at least 1 questionnaire), including 451 using open-source AID (mean age 43, SD 13 years; n=189, 41.9% women) and 141 nonusers (mean age 40, SD 13 years; n=90, 63.8% women). Adults using open-source AID reported significantly better general emotional well-being and subjective sleep quality, as well as better diabetes-specific QoL, positive well-being, and treatment satisfaction. They also reported significantly less diabetes distress, fear of hypoglycemia, and perceived less impact of the COVID-19 pandemic on their QoL. All were medium-to-large effects (Cohen d=0.5-1.5). The differences between groups remained significant after adjusting for sociodemographic and clinical characteristics. Adults with type 1 diabetes using open-source AID report significantly better psychosocial outcomes than those not using these systems, after adjusting for sociodemographic and clinical characteristics. Using validated, quantitative measures, this real-world study corroborates the beneficial psychosocial outcomes described previously in qualitative studies or using unvalidated study-specific items.

Comparison of Effects of Injectable Semaglutide and Dulaglutide on Oxidative Stress and Glucose Variability in Patients with Type 2 Diabetes Mellitus: A Prospective Preliminary Study.

Recent trials have shown that glucagon-like peptide-1 receptor agonists considerably reduce atherosclerotic cardiovascular disease in patients with type 2 diabetes mellitus (T2DM). Oxidative stress, a surrogate marker of cardiovascular risk, is associated with glucose variability. However, to the best of our knowledge, no studies have compared the effects of injectable semaglutide and dulaglutide therapies on oxidative stress and glucose variability assessed via continuous glucose monitoring (CGM). This study aimed to analyze and compare the effects of semaglutide and dulaglutide therapies on oxidative stress and glucose variability as assessed through CGM. This is an open-label, multicenter, randomized, prospective, parallel-group comparison study. Overall, 37 patients with T2DM treated with dulaglutide for at least 12weeks were randomized into two groups: one receiving continuous dulaglutide therapy (n = 19) and one receiving injectable semaglutide therapy (n = 18) groups. The coprimary endpoints were changes in the results of the diacron-reactive oxygen metabolites test, an oxidative stress marker, and CGM-evaluated glucose variability after 24weeks. The secondary endpoint was changes in the Diabetes Treatment Satisfaction Questionnaire (DTSQ) scores. Switching to semaglutide therapy was better than continuous dulaglutide therapy in reducing oxidative stress, glucose variability, and glycated hemoglobin levels. Conversely, continuous dulaglutide therapy was better than semaglutide therapy in terms of DTSQ scores for "Convenience" and "Recommend." Injectable semaglutide therapy may be more effective than dulaglutide therapy in ameliorating oxidative stress and regulating glucose metabolism, including glucose variability, in patients with T2DM, while dulaglutide therapy may be more effective in terms of treatment satisfaction. UMIN-CRT ID: UMIN000042670 (registered 7 December 2020).

Treatment Satisfaction and Quality of Life with Tirzepatide Versus Dulaglutide Among Japanese Patients with Type2 Diabetes: Exploratory Evaluation of the SURPASS J-mono Trial.

Treatment satisfaction in diabetes management is vital to achieving long-term clinical outcomes. This analysis evaluated treatment satisfaction among patients with type2 diabetes (T2D) after 52weeks of treatment with once-weekly tirzepatide (5, 10, and 15mg) compared with dulaglutide 0.75mg. This exploratory analysis of the phase3 SURPASS J-mono trial assessed treatment satisfaction using the Japanese translation of the Diabetes Treatment Satisfaction Questionnaire status (DTSQs) and change versions (DTSQc). Subgroup analyses were posthoc and conducted for the DTSQc overall treatment satisfaction score based on age (< 65 or ≥ 65years), sex (male or female), baseline body mass index (BMI; < 25 or ≥ 25kg/m2), and baseline glycated hemoglobin (≤ 8.5% or > 8.5%). Baseline DTSQs scores were similar among patients across all treatment arms. Overall, trends showed higher satisfaction among patients who received any tirzepatide dose compared with those who received dulaglutide after 52weeks of treatment. Mean overall DTSQc treatment satisfaction scores at week52 were significantly higher with tirzepatide 5, 10, and 15mg versus dulaglutide 0.75mg (11.5, 12.1, and 12.3, respectively, vs 8.9; P < 0.001). The DTSQc perceived frequency scores for unacceptable hyperglycemia were significantly lower with tirzepatide 5, 10, and 15mg versus dulaglutide 0.75 mg (- 1.7, - 1.8, and - 2.3, respectively, vs - 0.6; P < 0.001), while scores for unacceptable hypoglycemia were similar across all treatment arms, ranging from - 0.8 to - 1.1. Subgroup analyses showed increased treatment satisfaction with tirzepatide compared with dulaglutide in the < 65years (P < 0.001) and baseline BMI ≥ 25kg/m2 subgroups (P < 0.01 or < 0.001) and similar treatment satisfaction across treatment arms in the ≥ 65years and BMI < 25 kg/m2 subgroups. Patients with T2D reported higher treatment satisfaction with once-weekly tirzepatide (5, 10, and 15mg) compared with dulaglutide 0.75mg after 52weeks of treatment. ClinicalTrials.gov, NCT03861052.

Improved glycemic control after the use of flash glucose monitoring accompanied by improved treatment satisfaction in patients with non-insulin-treated type 2 diabetes: A post-hoc analysis of a randomized controlled trial

AimsIn our previously reported randomized controlled trial in patients with noninsulin-treated type 2 diabetes, the use of flash glucose monitoring (FGM) improved glycated hemoglobin (HbA1c), and the improvement was sustained after the cessation of glucose monitoring. In this post-hoc analysis, we examined data from our trial to identify the factors that influenced FGM efficacy. MethodsWe analyzed data for 48 of 49 participants of the FGM group who completed the trial to clarify the changes in various parameters and factors related to HbA1c improvement with the use of FGM. ResultsAnalyses of the FGM data during the 12-week FGM provision period showed that the weekly mean blood glucose levels considerably decreased as early as at 1 week compared with the baseline values, and this decline continued for 12 weeks. An enhancement in the Diabetes Treatment Satisfaction Questionnaire regarding “willingness to continue the current treatment” score was significantly associated with the improvement in HbA1c at 12 (p = 0.009) and 24 weeks (p = 0.012). ConclusionsGlycemic control was improved soon after FGM initiation, accompanied by improved satisfaction with continuation of the current treatment in patients with noninsulin-treated type 2 diabetes.

SAT123 Treatment Satisfaction And Barriers To Diabetes Care In Patients With Uncontrolled Diabetes Mellitus: A Cross-Sectional Study

Abstract Disclosure: S. Alghrid: None. O. Refadah: None. D. Alharbi: None. N. Aljuhani: None. S. Albalawi: None. S. Aljuhani: None. R. Alaradi: None. A. Yzeed: None. S. Albalawi: None. P. Amirthalingam: None. S.F. Alqifari: None. Background: Diabetes prevalence is reaching 25% in Saudi Arabia. Although diabetes care is provided free of charge, barriers to care and treatment satisfaction among patients remain unknown. Objectives: This study aims to examine diabetes patients’ treatment satisfaction and barriers to care in Saudi Arabia. Methods: We utilized the validated Diabetes Treatment Satisfaction Questionnaire (DTSQ) survey tool to assess diabetes treatment satisfaction among 782 adult Arabic-speaking patients with type 2 diabetes. An additional survey construct was utilized to assess patients’ perspectives on possible barriers to receiving diabetes care. Multivariate linear regression, r Pearson regression, and U Mann-Whitney tests were analyzed. Results: Of the 782 participants interviewed, 55.3% were females. The mean age of the study sample was 59.4 years. The average DTSQs value was 13.5. A strong correlation was observed between DTSQs score and glycemic control, female gender, and utilization of governmental healthcare. Patients of primary healthcare centers had higher satisfaction than tertiary care. Among the barriers to care reported, living in a rural area, transportation, and availability of appointments were the most frequent. Conclusion: Diabetes treatment satisfaction correlated well with glycemic control. The degree of treatment satisfaction in patients with type 2 diabetes was higher in female patients receiving government healthcare. Logistics constituted the most frequent barriers to care reported including living in rural areas, availability of transportation, and appointments. Presentation: Saturday, June 17, 2023

Patient satisfaction in three advanced hybrid closed-loop systems at 6 months of treatment in adults with type 1 diabetes mellitus: a follow-up study

IntroductionAdvanced hybrid closed-loop (AHCL) systems have demonstrated improved glycemic control in individuals with Type 1 Diabetes Mellitus. The aim of this study is to compare patient satisfaction among three available AHCL systems (Medtronic Minimed780 G, Roche Diabeloop DBLG1, and Tandem t:slim X2 Control IQ) after six months of treatment and to determine if it is related to glycemic control. MethodsThe data of 75 individuals were analyzed, including 15 using the DBLG1 system, 9 using Control IQ, and 51 using MM780 G. Patient satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire for Diabetes Mellitus (DTSQc), a validated instrument. ResultsAll systems demonstrated treatment satisfaction. The DBLG-1 system scored 14 (−15–21) points, while Control IQ scored 21 (9–24) and M780 G scored 19 (11–24) (p = 0.004). The multivariate analysis revealed that the DBLG-1 system is associated with a lower DTSQc score (OR 0.19, p = 0.019) independent of glycemic control, sex, age, duration of diabetes, duration as an insulin pump user, and daily insulin dose. ConclusionAHCL systems are satisfactory treatments for users, with potential variations observed between each system regardless of the achieved glycemic control.

Recovery of hypoglycemic confidence using intermittently scanned continuous glucose monitoring among adults with type 1 diabetes with level 3 hypoglycemia: A prospective, single-center, single-arm study

AimTo investigate whether the FreeStyle Libre, an intermittent scanning continuous glucose monitoring (isCGM) system, influences confidence in managing hypoglycemia in adults with type 1 diabetes. Materials and MethodsThis longitudinal, observational study conducted at one facility included 121 adults with type 1 diabetes. Participants used the conventional finger-prick method for self-testing glucose before using isCGM. At baseline and 12 months after initiating isCGM, the Hypoglycemic Confidence Scale (HCS), Diabetes Treatment Satisfaction Questionnaire (DTSQ), and HbA1c were performed. At 12 months, the percentage of individuals utilizing isCGM trend arrows for glucose management was observed. The primary endpoint was hypoglycemic confidence change attributed to using isCGM. ResultsAfter using isCGM, HCS scores improved significantly from 2.89 (2.56, 3.22) to 3.00 (2.20, 3.33) (p < 0.001); median (25%, 75%). Among participants with level 3 hypoglycemia at baseline, hypoglycemic confidence during sleep (p < 0.05), in social situations (p < 0.05), and in avoiding serious hypoglycemia-related problems (p < 0.05) were improved. Despite hypoglycemia risk, participants could continue daily activities by using isCGM (p < 0.05), and sixty-nine percent utilized trend arrows effectively. ConclusionUsing isCGM improved hypoglycemic confidence among adults with type 1 diabetes. Data analysis indicated that people with type 1 diabetes could live more freely and better manage hypoglycemia using isCGM.

The Japanese version of Problem Areas in Diabetes Scale: a clinical and research tool to assess emotional functioning among people with diabetes.

The purpose of this study was to develop the Japanese version of the Problem Areas in Diabetes (PAID) scale, a measure of emotional adjustment to diabetes that has been translated into Japanese by our group. A total of 418 Japanese people with diabetes attending our outpatient clinic participated (n = 65 type 1 and n = 353 type 2). We assessed the internal reliability of the PAID, examined correlations of the PAID with conceptually related psychosocial constructs, evaluated mean differences in the PAID between diabetes treatment groups, and examined correlations of the PAID with diabetes self-care behaviours and selected treatment outcomes. Results showed that the PAID had excellent reliability (Cronbach alpha = 0.934). The PAID correlated significantly with the Diabetes Treatment Satisfaction Questionnaire (r = -0.593, p < 0.0001) and the positive wellbeing (r = -0.396, p < 0.0001), negative wellbeing (r = -0.640, p < 0.0001) and energy (r = -0.444, p < 0.0001) subscales of the Wellbeing Questionnaire. Adherence to diet was negatively correlated with PAID score (r = -0.263, p < 0.0001). The frequency of recent hypoglycemia and number of chronic complications (retinopathy, nephropathy and neuropathy) were positively correlated with PAID scores. PAID was weakly correlated with HbA1c (r = 0.13, p = 0.01). In conclusion, the Japanese version of the PAID demonstrated good internal reliability and evidence of concurrent and discriminant validity. The PAID measures the impact of diabetes, diabetes treatment and treatment outcomes on the emotions of people with diabetes. The results provide encouraging evidence for the clinical utility of the PAID in Japanese people with diabetes.

The Effect of Do-It-Yourself Real-Time Continuous Glucose Monitoring on Glycemic Variables and Participant-Reported Outcomes in Adults With Type 1 Diabetes: A Randomized Crossover Trial.

Real-time continuous glucose monitoring (rtCGM) has several advantages over intermittently scanned continuous glucose monitoring (isCGM) but generally comes at a higher cost. Do-it-yourself rtCGM (DIY-rtCGM) potentially has benefits similar to those of rtCGM. This study compared outcomes in adults with type 1 diabetes using DIY-rtCGM versus isCGM. In this crossover trial, adults with type 1 diabetes were randomized to use isCGM or DIY-rtCGM for eight weeks before crossover to use the other device for eight weeks, after a four-week washout period where participants reverted back to isCGM. The primary endpoint was time in range (TIR; 3.9-10 mmol/L). Secondary endpoints included other glycemic control measures, psychosocial outcomes, and sleep quality. Sixty participants were recruited, and 52 (87%) completed follow-up. Glucose outcomes were similar in the DIY-rtCGM and isCGM groups, including TIR (53.1% vs 51.3%; mean difference -1.7% P = .593), glycosylated hemoglobin (57.0 ± 17.8 vs 61.4 ± 12.2 mmol/L; P = .593), and time in hypoglycemia <3.9 mmol/L (3.9 ± 3.8% vs 3.8 ± 4.0%; P = .947). Hypoglycemia Fear Survey total score (1.17 ± 0.52 vs 0.97 ± 0.54; P = .02) and fear of hypoglycemia score (1.18 ± 0.64 vs 0.97 ± 0.45; P = .02) were significantly higher during DIY-rtCGM versus isCGM. Diabetes Treatment Satisfaction Questionnaire status (DTSQS) score was also higher with DIY-rtCGM versus isCGM (28.7 ± 5.8 vs 26.0 ± 5.8; P = .04), whereas diabetes-related quality of life was slightly lower (DAWN2 Impact of Diabetes score: 3.11 ± 0.4 vs 3.32 ± 0.51; P = .045); sleep quality did not differ between the two groups. Although the use of DIY-rtCGM did not improve glycemic outcomes compared with isCGM, it positively impacted several patient-reported psychosocial variables. DIY-rtCGM potentially provides an alternative, cost-effective rtCGM option.

Determinants of treatment satisfaction among patients with diabetes: multicentre cross-sectional study in Northwest Ethiopia

ObjectiveTreatment satisfaction is a significant determinant of quality of care, especially for patients with chronic diseases such as diabetes. Identifying factors that contribute to treatment satisfaction may improve patient outcomes....

An educational programme and patient‐reported outcomes using flash glucose monitoring and automated bolus calculation in type 1 diabetes

AbstractIntroduction: Our primary aim was to describe the educational programme and user's guide for decision support for persons with type 1 diabetes who commence carbohydrate counting with automated bolus calculator (ABC) and flash (intermittently scanned) glucose monitoring (isCGM). The programme was developed for the ABC Flash trial, conducted in The Capital Region of Denmark in 2018–2020. We also aimed to evaluate the impact of the programme and the combined interventions on patient‐reported outcome parameters.Methods: The programme and user's guide are described in detail. In total, 35 adults with type 1 diabetes and sub‐optimal HbA1c treated with multiple daily insulin injections completed the 26‐week educational programme on initiating ABC and isCGM. Patient‐reported outcomes were self‐evaluated before and after (Audit of Diabetes Dependent Quality of Life questionnaire, Diabetes Treatment Satisfaction Questionnaire, Problem Areas in Diabetes and Diabetes Empowerment Scale). Changes over time in the different sub‐areas of diabetes‐related burden on quality of life, treatment satisfaction, diabetes‐related distress and psychosocial self‐efficacy were analysed.Results: During participation in the educational programme on initiating ABC and isCGM, diabetes‐related burden on work and sex life and several treatment satisfaction and psychosocial self‐efficacy sub‐areas improved.Conclusion: Implementation of the educational programme and initiating combined intervention with carbohydrate counting with ABC and isCGM improve treatment satisfaction and different psychosocial areas among persons with type 1 diabetes. Copyright © 2023 John Wiley &amp; Sons.

Satisfacción del paciente en tres sistemas avanzados de asa cerrada híbrida a los 6 meses de tratamiento en adultos con diabetes mellitus tipo 1: un estudio de seguimiento

IntroductionAdvanced hybrid closed-loop (AHCL) systems have demonstrated improved glycemic control in individuals with Type 1 Diabetes Mellitus. The aim of this study is to compare patient satisfaction among three available AHCL systems (Medtronic Minimed780G [MM780G], Roche Diabeloop DBLG1, and Tandem t:slim X2 Control IQ) after six months of treatment and to determine if it is related to glycemic control. MethodsThe data of 75 individuals were analyzed, including 15 using the DBLG1 system, 9 using Control IQ, and 51 using MM780G. Patient satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire for Diabetes Mellitus (DTSQc), a validated instrument. ResultsAll systems demonstrated treatment satisfaction. The DBLG-1 system scored 14 (-15 – 21) points, while Control IQ scored 21 (9 – 24) and MM780G scored 19 (11 – 24) (p=0.004). The multivariate analysis revealed that the DBLG-1 system is associated with a lower DTSQc score (OR 0.19, p=0.019) independently of glycemic control, sex, age, duration of diabetes, duration as an insulin pump user, and daily insulin dose. ConclusionAHCL systems are satisfactory treatments for users, with potential variations observed between each system regardless of the achieved glycemic control.

Quality of Life and Treatment Satisfaction In Type I Diabetic Patients Treated with Subcutaneous Insulin Multiple Daily Injections

Background: Diabetes represents a major health problem because of its high prevalence, morbidity and mortality, its influence on patient quality of life and its impact on the health system. This impact involves the physical and emotional overload of diabetes, a disease that requires life-long treatment, including lifestyle and pharmacological measures, often with multiple drugs. Quality of life QOL is regarded as a subjective measure of health and well-being related to a disease. Treatment satisfaction is a subjective measure that evaluates the patient's experience of the processes and results of treatment. Furthermore, it is understood that poor satisfaction with treatment compromises treatment adherence. Aim: The aim of this case-control study was to determine and explore the quality of life QOL and treatment satisfaction in patients with Type 1 diabetes (T1DM) treated with subcutaneous insulin multiple daily injections (MDI). Subjects and Method: Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed a pre-validated questionnaire created from the Diabetes-Specific Quality-of-Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF-36 Health Survey (SF-36). Results: The result of this study shows that there is no difference in distribution between genders; 53.3% males and 46.7 females. Moreover, the largest percentage of age was between 46-55 (50%). Patient satisfaction presented at a higher percentage in males 81.3%, graduates 40% and patients aged 26-35 (80.0%). Conclusion: To conclude, diabetes Type 1 is a common condition and is considered a significant public health concern that significantly increases the risk of health problems. Health-related quality of life (HRQOL) is considered a multi-dimensional concept that includes domains related to the effect of both physical and mental health perception and their correlates such as the health risks and conditions.

Association of treatment satisfaction and physician trust with glycemic control among primary care patients with type 2 diabetes in Egypt.

To evaluate the association of diabetes treatment satisfaction and trust in family physicians with glycemic control among primary care patients with type 2 diabetes mellitus. A cross-sectional study on 319 patients with type 2 diabetes mellitus from five primary healthcare centers in Egypt. Data were collected from February to August 2021 using a structured questionnaire that contained six parts: sociodemographic data, disease profile, the Diabetes Treatment Satisfaction Questionnaire (DTSQ), 8-item Morisky Medication Adherence Scale (MMAS-8), self-reported medication knowledge questionnaire (MKQ), and revised healthcare relationship trust scale (HCR). Multiple linear regression analysis was used to assess predictors of treatment satisfaction, physician trust, and HbA1c level. P values less than 0.05 were considered significant. The mean age was 59.66 years (± 7.87 years) and 55.17% were females. Multiple linear regression analysis for predicting HbA1c showed that HbA1c level was lower in patients with higher treatment satisfaction scores (β = - 0.289, p < 0.001) and higher medication adherence scores (β = - 0.198, p = 0.001). Treatment satisfaction scores were positively predicted by higher physician trust scores (β = 0.301, p < 0.001), increased medication adherence scores (β = 0.160, p = 0.002), and longer duration of diabetes (β = 0.226, p < 0.001). Positive predictors for physician trust included HbA1c level (β = 0.141, p = 0.012), medication knowledge (β = 0.280, p < 0.001), diabetes treatment satisfaction (β = 0.366, p < 0.001) and medication adherence (β = 0.146, p = 0.011). Optimizing diabetes treatment satisfaction and physician trust could have favorable associations with medication adherence and medication knowledge with a possible improvement in glycemic control. Family physicians should incorporate patients reported outcomes alongside traditional clinical measures in evaluating diabetes management in primary care.